Clinical and genomic responses to ultra-short course chemotherapy in spinal tuberculosis

Abstract

Traditional treatments for spinal tuberculosis (TB) involve chemotherapy and surgery. In the present study, it has been identified that chemotherapy lasting <6 months [ultra-short course chemotherapy (UCCT)], rather than the 6–18 months of the traditional regimen, is effective in sustaining TB clearance following complete surgical debridement. This current study aims to compare the changes in peripheral blood gene expression prior to and following UCCT, subsequent to complete debridement of spinal TB lesions. The study includes 5 patients without TB and 27 patients with spinal, divided into three groups: Group 1 (untreated group, n=8); group 2 (UCCT treatment group, n=9); and group 3 (UCCT treatment 1 year follow-up group, n=10). Gene changes were detected using DNA microarray analysis, confirmed through reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and the results were examined using the DAVID Knowledgebase to identify the pathways and functions of differentially expressed genes. TB lesions were active in group 1, while groups 2 and 3 showed no signs of active TB, as indicated by clinical manifestations and imaging. Comparison of the transcription profiles of the control and study groups showed that treatment of spinal TB resulted in upregulation of genes that are associated with immune response pathways; RT-qPCR produced similar findings. In conclusion, these results indicate that UCCT is an effective treatment against TB following complete surgical debridement. Furthermore, DNA microarray analysis proved a useful tool to evaluate the effects of spinal TB treatment on the expression of genes associated with immune response pathways.

Caries Spine: A Comparative Study between Medical Management Alone with Combined Medical and Surgical Management

“…In contrast, we found significant difference between neurological outcomes inboth groups (as shown in Table 1 and 2). Ningkui 8 found medical treatment lasting < 6 months [ultrashort course chemotherapy (UCCT)], rather than the traditional 6-18 months, was effective in sustaining TB clearance after surgical debridement.Other studies such as Mirkoohi 27 , Ekinci 28 , Varatharajah and Charles also advocate surgical intervention as having superior results. 29 Major complications encountered in our study were respiratory infections in four (10%) and wound infection in two (5%) patients.…”

Plasma metabolomic analysis reveals the metabolic characteristics and potential diagnostic biomarkers of spinal tuberculosis

“…Spinal tuberculosis (STB), an extrapulmonary manifestation of tuberculosis (TB) caused by Mycobacterium tuberculosis ( MTB ), is the most common form of osteoarticular TB, accounting for over 60% of all cases [ 1 , 2 ]. It is associated with multiple RNAs, involves multiple signaling pathways, and has a complex pathogenesis [ [3] , [4] , [5] ]. The onset of STB is slow.…”

Preparation, characterization, and in-vitro cytotoxicity of nanoliposomes loaded with anti-tubercular drugs and TGF-β1 siRNA for improving spinal tuberculosis therapy

“…STB was treated with first-line anti-TB therapeutics such as INH (H), RIF (R), and PZA (Z). Furthermore, the histopathology of TB, the pharmacokinetics of anti-TB drugs, and the drug resistance mechanism of Mtb have been studied in depth [6][7][8][9][10][11][12][13][14][15][16]. A significant difference was observed in the distribution of anti-TB drugs in STB.…”